Consent Form

Name*

First Last

Address*

Street Address Address Line 2 City/Town County Post Code Country

Phone*

Email*

Date of birth

We'll never disclose your age without your consent, but it helps us monitor diversity within our storytellers.

Your consent preferences

Please read through the options below and select all of the ways you are happy for your content to be shared:

Your consent preferences

Select All
For media, press and publicity opportunities (including newspapers, magazines, radio, TV, etc)
On the National Garden Scheme website and National Garden Scheme-owned social media channels (Facebook, LinkedIn, YouTube, Instagram, Twitter, TikTok, etc)
In fundraising and awareness-raising communications (such as fundraising appeals, donor communications, and printed and online fundraising materials)
In printed and online publications (annual reports, information booklets and resources, etc)
In printed and online partnership communications (such as communications or promotions for corporate partners, etc)
I would be interested in speaking at events and sharing my story

What is the name of the staff member at the National Garden Scheme that contacted you about this consent form?

Staff member name

Your restrictions and comments

Your story will not be used for any longer than 5 years. You can ask us to stop using it before then by emailing [email protected]. The consent form and any content you have shared with us will be stored on a secure system. Once your consent expires, we will either be in touch to renew it or we will archive (keep, but not use) your content and associated records for 7 years after your consent expiry date or the date you withdraw consent. Please select each of the boxes below to indicate your explicit consent for your contact details and for your content to be stored, and shared, by the National Garden Scheme in our communications:

Your restrictions and comments

Select All
I understand that my material will be stored and used for up to 5 years unless otherwise specified below.
I consent that if I have shared my health diagnosis and other health details with the National Garden Scheme, they may be used in promotional materials.
You must request my permission each time you wish to use my content. Please be assured that if your content is going to be used in the media or mass market advertising, you will be contacted to ensure you are happy for it to be used in this way.

If you have any other restrictions or comments, please let us know now:

Can we use your real name?

You can choose to have your real name published with your story or remain anonymous.

Can we use your real name?*

I am happy for my real name to be used
I do not want my real name to be used, I'd like to remain anonymous

Withdrawing or changing consent

You can withdraw or change your preference for the use of your content at any time. If you no longer wish to share your story or want to change how it is used, contact us at [email protected] and we will act on your decision within 30 days. It may not always be possible to withdraw materials already published or issued before you withdrew consent.

Diversity monitoring information

This part of the form is completely optional. We are committed to a policy of equal opportunities and we welcome the sharing of lived experiences from all backgrounds. This information helps us understand the diversity of the people we work with. This information will be used to help ensure we are proactively including a range of voices in our press and marketing materials. This information will be held in line with the National Garden Scheme's privacy policy. National Garden Scheme may share anonymised data with our Senior Leadership team, our Equality, Diversity and Inclusion Lead, Committees and Trustees.

What best describes your gender?

Female
Male
Prefer not to say
Prefer to self-describe

How would you self describe?

What is your ethnicity?

Asian or Asian British
Arab
Black, Black British, Caribbean, or African
Latin American
White
Mixed or multiple ethnic groups
Prefer not to say
Prefer to self-describe

How would you self-describe?

What is your religion?

No religion
Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
Prefer not to say
Prefer to self-describe

How would you self-describe?

Do you have a disability?

Yes
No
Prefer not to say
Prefer to self-describe

Defined as: you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.

How would you self-describe?

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National Garden Scheme Consent Form

Your consent preferences

What is the name of the staff member at the National Garden Scheme that contacted you about this consent form?

Your restrictions and comments

Can we use your real name?

Withdrawing or changing consent

Diversity monitoring information

What best describes your gender?

What is your ethnicity?

What is your religion?

Do you have a disability?

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By completing this form, you confirm that you are aged 18 years or over and that you are happy to receive emails from the National Garden Scheme in accordance with our Privacy Policy. We will never share your details with anyone else without your express permission.

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